Repair of Abdominal Wall Defects by Intraperitoneal Implantation of Polytetrafluoroethylene (Teflon®) Mesh

Abstract

The surgical management of major abdominal wall defects or incisional hernias remains controversial. Although primary musculofascial repair is sufficient for many patients, moderate or large hernias and refractory cases may require the use of a prosthesis. Various prosthetic materials have been described and tested over the years. In theory, the ideal material must be strong, biologically inert, noncarcinogenic, and resistant to infection. Many materials have been developed, but there is no agreement on which is best. Importantly, the most effective positioning of the prosthesis is also a subject of debate, with some preferring intraabdominal placement and others opting for the extraperitoneal position. Many studies have been performed with various materials and techniques but provide no clear answers as to the optimal management of abdominal hernias. In this chapter, we first discuss two of the commonly used prosthetic materials, polypropylene (Marlex®) and expanded polytetrafluoroethylene (ePTFE Gore-Tex®) and then report our experience with polytetrafluoroethylene (PTFE) mesh (Teflon®), a prosthesis that we use routinely in the management of incisional hernias and abdominal wall defects and that we believe has the best profile in terms of ease of use and low complication and recurrence rates.